Associations between the neighbourhood environment characteristics and physical activity in older adults with specific types of chronic conditions: the ALECS cross-sectional study

Abstract

BackgroundNeighbourhood characteristics may influence physical activity (PA), which has positive effects on the health of older adults. Older adults with chronic conditions are less active and possibly more affected by environmental factors than their peers. Understanding neighbourhood characteristics associated with PA specific to older adults with chronic conditions is currently lacking. This cross-sectional study aimed to assess the associations between the neighbourhood environment and various forms of PA in older adults with and without visual impairment, hearing impairment, musculoskeletal disease and/or genitourinary disease.MethodsNeighbourhood environment and PA data were collected in Hong Kong older adults (N = 909) from 124 preselected neighbourhoods stratified for walkability and socioeconomic status. Generalized linear models and zero-inflated negative binomial models with robust standard errors were used to examine associations of perceived neighbourhood environment characteristics, and the moderating effects of having specific chronic conditions, with PA outcomes.ResultsThirteen perceived neighbourhood characteristics were associated with older adults’ PA in the expected direction irrespective of their health condition. Nine neighbourhood characteristics had associations with PA that were dependent on hearing impairment, vision impairment, musculoskeletal disease or genitourinary disease. In general, they were stronger in participants with than without a specific chronic condition.ConclusionsMaximizing the potential for PA in older adults who have lower levels of physical functionality due to chronic conditions may require neighbourhood characteristics specific to these groups.

The Neighbourhood Physical Environment and Active Travel in Older Adults: A Systematic Review and Meta-Analysis

“…Most articles (83.3%) presented findings on environmental correlates of total walking for transport operationalised as a categorical, discrete or continuous outcome using a wide variety of questionnaires and different criteria of categorization/dichotomization. Only four articles, all from Hong Kong [4,[56][57][58], examined within-neighbourhood walking and two Belgian articles studied cycling for transport [6,25].…”

“…Only four articles from two Hong Kong studies examined neighbourhood environmental correlates of withinneighbourhood walking [4,[56][57][58]. Strong evidence was found for positive associations with overall access to destinations/services, land use mix -destination diversity, parks/open space/recreational destinations, pedestrianfriendly features and easy access to building entrance (Table 3).…”

“…Age, sex, education [58] and chronic conditions [4] were investigated as moderators of within-neighbourhood walking only in single studies (Table 5). Land use mixdestination diversity and the presence of benches and sitting facilities were identified as significant correlates in older (75+ year olds) but not younger senior residents (65-74 year olds) [58].…”

“…Active travel (AT), here defined as walking or cycling to a destination, can contribute substantiality to the accumulation of health-enhancing levels of PA in older adults. Older adults from Hong Kong, Chicago (USA) and Ghent (Belgium) reported AT accounted for 55% (169 min) of walking within the neighbourhood, 56% (159 min) of total walking and 42% (123 min) of total PA, respectively [4][5][6]. Changes in active commuting have been associated with corresponding changes in total PA without compensatory changes in leisure-time PA, suggesting a net benefit from engaging in AT [7,8].…”

Relationships between Neighborhood Walkability and Objectively Measured Physical Activity Levels in Hemodialysis Patients

“…Urbanicity of residence (i.e., urban, suburban, rural) as well as neighborhoods environment have been shown to be associated with physical activity levels in the general and HD populations [10-14]. Despite this, specific neighborhood characteristics have in some cases not been identified to be associated with physical activity levels in older adults and those with chronic illness [15-17]. …”